Body Essential Physical Therapy and Massage, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03533 Issued in OR

Legal business name

BODY ESSENTIAL PHYSICAL THERAPY AND MASSAGE, LLC

Practice address

1032 SE Lane Ave
Roseburg, OR 97470-3956

Phone

(541) 784-7771

Fax

(541) 672-1466

NPI assigned

Apr 1, 2015

Last updated

May 24, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer HawksNPI 1033341920

Title

Sole Proprietor Owner and Staff

Phone

(541) 784-7771

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Ann Hawks, PHYSICAL THERAPIST

  • Physical Therapist
  • Roseburg, OR
  • NPI 1033341920
  Medicare reassignment NPD Authorized official
• Amber Rodriguez Hill

  • Physical Therapy Clinic/Center
  • Roseburg, OR
  • NPI 1871030197
  NPD (past)
• Hyun Gyung Pyo, P.T.A.

  • Physical Therapy Assistant
  • Rosebury, OR
  • NPI 1972038974
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1396130894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 OAKVIEW DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974719519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 SE LANE AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703956",
            "telephone_number": "541-784-7771",
            "fax_number": "541-672-1466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY ESSENTIAL PHYSICAL THERAPY AND MASSAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-01",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "HAWKS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SOLE PROPRIETOR OWNER AND STAFF",
        "authorized_official_telephone_number": "541-784-7771"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "03533",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "13630",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Ann Blaine
• Stephanie Bland
• Carly Blemmel, MSHR. LPC
• Holly Block, MA, NCC
• Steven Allen Blum, M.D.
• Burnell Jason Boehland
• Joshua Andrew Boele, PA-C
• Craig Boerste
• Brian K Bogardus, DMD
• Kaitlyn E Bogardus, PA-C

• Physical Therapist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.